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Magical Melatonin, Amended

Good sleep is magical, right? We drift gently from the world as we know it and enter another realm. We may battle dragons or empty bed pans or may remember nothing at all. We may sleep through a fire siren or the alarm clock, but we can be awakened with enough effort. And then, we return to life with our brains and attitudes refreshed.The world is a sunnier place, jokes are funnier, and everything falls into place. Turns out that inside your body everything is just as happy, and it’s primarily the work of the melatonin that made your sleep so restful.

Melatonin is well recognized for its ability to prevent jet lag and to confer sleep on the sleepless. Conventional recommendations for melatonin supplementation suggest that 0.5-3.0 mg, taken for a brief period of time, can be helpful without significant risk.

I would agree with that cautious recommendation, but want to tell you more about melatonin, and my own suggestion that people over the age of 50 (or others who can't boost their own internal melatonin) consider taking a fair amount more melatonin that that.

What Is Known About Sleep and Melatonin

Melatonin is made primarily in the pineal gland, deep in the brain, and in the intestinal tract. It is also made in bones, eyes, skin, the thymus gland and certain types of blood cells. The fact that melatonin is made in so many parts of the body suggests that it is doing more than helping us sleep at night.

Starting With Sleep

Yes, melatonin has been shown in many studies to help with sleep, reducing the time needed to go to sleep and improving the quality and length of sleep. You could write a book about the many benefits of regular sleep, and the many ways to get a good night's sleep. It's always important to start with the lifestyle suggestions for sleeping well and to stick with them, even if they're not enough! Sleeping in a dark room and maintaining a routine sleeping schedule provides a benefit, even if you're taking a handful of supplements to ensure that the sleep you want really comes.

Cancer Reduced With Melatonin

Several different relationships have been observed between cancer incidence and melatonin levels. For postmenopausal women, those with the lowest levels of melatonin (measured in the urine), have a higher risk of breast cancer. For men, those with higher levels of melatonin are less likely to develop prostate cancer. Additionally, various cancer types have been shown to be responsive to oral melatonin (10-50 mg daily), including breast cancer, non-small-cell lung cancer, metastatic renal cell carcinoma, hepatocellular carcinoma, and brain metastases from solid tumors.

Cardiovascular Health

Melatonin has also been reported to lower LDL- and total cholesterol levels, and to lower blood pressure, particularly in post-menopausal women on HRT (increased nitric oxide) but in others as well, by other mechanisms. Low levels of melatonin are associated with increased risk of heart attacks.

Immune Health

Melatonin is a powerful anti-inflammatory and anti-oxidant and contributes some effect to immune system balancing that gets out of whack in auto-immune disease. Low melatonin levels are a risk factor for multiple sclerosis, but supplementation has not been shown to reduce disease symptoms. Individuals with an auto-immune disease would be wise to work with a melatonin-savvy physician to personalize an approach that might be helpful.

Neurological Health

Both epilepsy and migraine headaches have been improved with careful administration of melatonin. Migraine sufferers who took 3-5 mg of melatonin at night for one month saw a significant reduction in the intensity and frequency of their headaches.

Downside of melatonin, 2016 update

Melatonin has a not so desirable effect on metabolism: melatonin suppresses insulin release and can raise blood sugar levels. This is a good reason to pursue multiple avenues of sleep therapies, not just take high levels of melatonin. A wise path would be to make sure you have normal levels of melatonin, whether naturally or by low dose supplementation to achieve normal levels. You can't, sadly, test melatonin through a blood test, but only through special urine tests. DUTCH testing is the easiest urine testing system available and must be ordered by your doctor.

Making Your Own Wonder Drug

If you suspect you might be low in melatonin (most insomniacs are), you would be wise to first try to boost your own melatonin. The first step is to follow smart sleep suggestions: they really do work by optimizing conditions for melatonin production. Keeping a regular sleep schedule enables you to sync your melatonin levels and your activities. Light at night (even if your eyes are closed) can lower melatonin levels, so the completely dark room is a good idea. Your eyes are the most important, so a sleep mask is a decent compromise if a dark room is impossible. Many of the other sleep suggestions are really ways to keep your own cortisol levels down: cortisol is melatonin's natural antagonist and if it gets too high, melatonin won't be effective for you. (In fact, keeping cortisol levels in check is one of the benefits of a healthy level of melatonin. Add that to the above list.)

Beyond orchestrating a wise sleep routine, there are certain foods that are rich in melatonin or its precursors. Those foods include tomatoes, olives, barley, rice, walnuts, grapes and milk. Get this: milk produced at night time actually has higher levels of melatonin that day-time milk; of course that makes sense, as the mother (or cow) making the milk has higher blood levels of melatonin. I don't know if you can order "night milk" from your local grocer, but hey, it might be what saves a failing dairy industry. Coffee and alcohol also theoretically have melatonin, but their overall effect on sleep is not beneficial, so forego alcohol and caffeinated coffee for four to eight hours before bed. Okay, I have a great idea: decaffeinated coffee with night milk would actually be okay. Let me know if you find it.

You can also get yourself a bit of personal insurance by taking the two tryptophan precursors to melatonin: l-tryptophan (500-1000 mg) and 5-hydroxy tryptophan (50-100 mg) can be taken singly or together to make sure the raw ingredients are available for melatonin production.

For your body to be effective at making melatonin, certain nutrients act as key co-factors and must be adequate. The most important ones are B vitamins (especially folate and B6), magnesium, zinc and vitamin D. Find folate in a methylated form (800 mcg) and B6 at a dose of about 25 mg, and those can be taken at night-time. Magnesium glycinate is a particularly calming form of magnesium: you can take as much as you can tolerate without getting loose bowels. Zinc is abundant in animal protein, absorption enhanced if you include some vitamin C (tomatoes?) with your burger, and can be supplemented at 15-30 mg daily if your levels are low.

Vitamin D is the only one that should be taken in the morning (oh, and that's when you should take your vitamin B12 as well), and the dose depends on your level. Take what is needed of vitamin D3 to maintain a blood test level of 40-65 ng/mL.

Melatonin For All

Say you do all those things, and you're still not sleeping enough to feel comfortable about your melatonin levels. What's probably going on is that you're either past a certain age (melatonin levels seem to decline with age), taking a drug that interferes with melatonin (beta-blockers are big offenders, also non-steroidal anti-inflammatories and aspirin), or might have a genetic predisposition to be challenged in this area. So what to do...

I recommend two key areas of supplementation for full melatonin effectiveness. (Need I say this? IN ADDITION to the lifestyle and supplement suggestions listed above!)

First, you can actually take melatonin, in doses starting as low as 0.5 mg, but seriously--if you're a stubborn insomniac, you will need higher doses. Particularly if you are over 50, you can feel comfortable bumping it up until you are sleeping. Take melatonin 30-120 minutes before bed, and taking it with food might enhance absorption. Start with 5 mg nightly for a few weeks, see how you do. Double it for a few weeks. Bump up another 5 if need be. Obviously this can get spendy, but so is life without good sleep. The side effects of melatonin are few and transient: if it makes you sleepy or gives you a headache, try a different kind. If the effect persists, it's not for you. Most folks sleep well before they get to 25 mg, particularly if they follow the lifestyle and other supplement advice above, and the second step, here it is:

Second, since one of the ways melatonin works for you is to stimulate GABA receptors, you can help with that process. Our neurotransmitters are very complex, but one system involves a two-way street in which glutamate (Awake! Alert! Excited!) transforms into GABA (Zzzz, what did you say? so calm....) and back again. You might get stuck in glutamate land and need help reminding yourself what GABA feels like. You can take GABA directly (1000-3000 mg up to three times a day), or you can take highly effective PharmaGABA (100-300mg) or GABA's precursor, L-theanine, 500-1500 mg. While you would just want to take melatonin in that pre-sleep window, you can take GABA throughout the day as needed, if you're the energizer bunny and don't know how to calm down.

Pulling It All Together

Melatonin is a naturally produced wonderfully protective hormone that our bodies make very naturally and easily when we are younger and in an optimal health state. The wide-ranging benefits of melatonin, however, should not be limited to those lucky enough to be living in a self-sufficient state of bountiful melatonin! There are many options, starting with healthy lifestyle measures, but also including wise supplementation, so that hearty and healthy melatonin levels -- and mostly reliable good sleep -- should be available to everyone.

This information is provided for educational purposes only, and any individual diagnosis or treatment should be determined by you and your doctor. See Additional Information.

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Good sleep is magical, right? We drift gently from the world as we know it and enter another realm. We may battle dragons or empty bed pans or may remember nothing at all. We may sleep through a fire siren or the alarm clock, but we can be awakened with enough effort. And then, we return to life with our brains and attitudes refreshed.The world is a sunnier place, jokes are funnier, and everything falls into place. Turns out that inside your body everything is just as happy, and it’s primarily the work of the melatonin that made your sleep so restful.

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